What’s the difference between an EHR and an EMR? The digital age in health care requires us to keep track of a veritable alphabet soup of acronyms! While the terms EHR and EMR are often used interchangeably, the explanation given by the U.S. National Coordinator for Health Information Technology (ONC) at the Department of Health & Human Services is that the EHR (Electronic Health Record) focuses “on the total health of the patient–going beyond standard clinical data collected in the provider’s office and inclusive of a broader view on a patient’s care. EHRs are designed to reach out beyond the health organization that originally collects and compiles the information. They are built to share information with other health care providers, such as laboratories and specialists, so they contain information from all the clinicians involved in the patient’s care… EHRs are designed to be accessed by all people involved in the patient’s care–including the patients themselves.” The EMR is a digital version of the paper chart in a physician’s office. In this article, then, we will use the term “EHR.” What are the benefits of using an EHR? Most EHRs include an entire suite of practice management tools in addition to the standard chart. Progress note templates and intake, assessment, and treatment planning forms are often included. Some EHR developers are now adding integrated video conferencing modules to their software to make initiating online sessions a point and click option. Online EHR’s offer the added convenience of being able to access your client’s chart and contact data from any device anywhere with internet access. If I use an EHR does it have to be online? Stand-alone software that you load onto your personal computer is an option. No internet connection is necessary although frequent back-ups to a thumb drive or data CD are required to avoid loss of data in the event of unexpected adverse circumstances like natural disasters, fires or theft. How do online EHRs work? Online EHRs are generally accessed over the internet through a secure browser window on your PC or Mac. Many vendors are now adding apps, which can be purchased for an additional charge, for convenient access on mobile devices. Can I be sure my online EHR is HIPPA compliant? The developer of your software should provide documentation of their security measures and compliance with HIPPA standards. You might also look for software that has been certified by the Certification Commission for Health information Technology (CCHIT®1), an ONC-ATCB, in accordance with the applicable certification criteria for Eligible Providers adopted by the Secretary of Health and Human Services. NOTE: such certification does not represent an endorsement by the U.S. Department of Health and Human Services. What about all of my paper notes? While you can keep all of your paper notes filed as usual, many clinicians scan and upload archived paper records into their EHR software. Can I avoid using either the EHR and EMR? Yes, any professional can choose to avoid using the EHR and EMR. However, starting in 2015, physicians who do not use a certified EHR or EMR system or cannot demonstrate “meaningful use” by the deadline will receive a 1% reduction in reimbursement from Medicare. That rate increases to 2% in 2016, 3% in 2017, 4% in 2018, and up to 95% depending on future adjustments. How this penalty system will impact allied mental health professionals is not yet clear. However, it appears that the autorities are taking the adoption of these record systems quite seriously, and it is reasonable to assume that allied mental health professionals will not be immune to their influence. I’m already spending too much on running my practice. Is it expensive to adopt and EHR? Typical monthly costs can range from $30 – $150 per month depending on the features and technical and administrative support you want from your software provider. One reasonably priced option for mental health professionals is Office Ally ($30/month per user.) Some companies charge a set-up fee in addition to a monthly charge. There are also free options, which are not specifically designed for mental health providers but can be adapted to our needs. An example is Practice Fusion.
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